Low levels of interleukin-1 receptor antagonist (IL-1RA) predict engraftment syndrome after autologous stem cell transplantation in POEMS syndrome and other plasma cell neoplasms

Alla Keyzner, Anita D'Souza, Martha Lacy, Morie Gertz, Suzanne Hayman, Francis Buadi, Shaji Kumar, David Dingli, Ann Engebretson, Caili Tong, Angela Dispenzieri

Research output: Contribution to journalArticle

7 Scopus citations


A rare, multisystem, plasma cell neoplasm, POEMS (polyradiculoneuropathy, organomegaly, endocrinopathy, M-spike, skin changes) syndrome is characterized by an abundance of proinflammatory and angiogenic cytokines. Patients with POEMS are known to have a high incidence of engraftment syndrome after autologous stem cell transplantation. We conducted a pilot study assessing levels of 30 different pro- and anti-inflammatory cytokines before and serially after transplantation in 18 patients with plasma cell neoplasms: POEMS syndrome (n=9), multiple myeloma (n=4), and amyloidosis (n=5). We show that POEMS patients have higher pretransplantation levels of IL-4, IL-10, IL-13, IFN-α, and EGF as compared with those with non-POEMS plasma cell neoplasms. Higher pre- and posttransplantation IL-13 levels correlated with delayed neutrophil engraftment in POEMS patients. Low posttransplantation IL-1RA levels correlated with engraftment syndrome in both POEMS and non-POEMS patients. We conclude that differences in the peri-transplantation cytokine milieu may explain the higher transplantation morbidity in patients with POEMS syndrome. Our results need validation in a larger cohort.

Original languageEnglish (US)
Pages (from-to)1395-1398
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Issue number9
StatePublished - Sep 2013



  • Cytokines
  • IL-13
  • IL-1RA
  • Neutrophil engraftment

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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